Bassan M M, Shalev O, Eliakim A
Heart Lung. 1984 Mar;13(2):164-8.
We reviewed 14 randomized controlled trials that involved long-term treatment of patients after myocardial infarction with beta-blockers. Studies in which randomization was carried out at the time of hospital admission were excluded because of a very high rate of early withdrawal before hospital discharge. Seven studies were found methodologically acceptable, and their results were analyzed according to the "intention-to-treat" principle to avoid bias caused by late withdrawals. Although only two of the trials found a significant reduction in total deaths in the beta-blocker groups, pooling the data from all seven studies showed a highly significant treatment benefit (p less than 0.001). The best estimate of the magnitude of the reduction in mortality rates is 26%. Pooling of the data revealed similarly significant reductions in the rates of reinfarction (p less than 0.001) and sudden death (p less than 0.001).
我们回顾了14项随机对照试验，这些试验涉及用β受体阻滞剂对心肌梗死后患者进行长期治疗。由于入院时进行随机分组的研究在出院前早期退出率非常高，因此被排除在外。发现7项研究在方法学上是可接受的，并根据“意向性治疗”原则对其结果进行分析，以避免因后期退出导致的偏差。尽管只有两项试验发现β受体阻滞剂组的总死亡人数显著减少，但汇总所有7项研究的数据显示出高度显著的治疗益处（p<0.001）。死亡率降低幅度的最佳估计值为26%。数据汇总显示，再梗死率（p<0.001）和猝死率（p<0.001）也有类似的显著降低。
